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Abstract: Rotational atherectomy is the treatment of choice for calcified coronary lesions. It should not be used routinely but only in some appropriate cases, especially when the successful deployment of a stent may be uncertain. Complications are rare but serious. Several cases of “off label” use, however, have been reported in the literature without additional complications. [Copyright &y& Elsevier]

Abstract: In the hands of experienced operators, the rate of success of percutaneous coronary intervention for chronic total occlusion lesion is about 85%. Major cardiac events rate is about 2%. A length of the occluded site more than 20mm, severe calcifications, major tortuosity, blunt stump and a previous attempt by anterograde approach are predictors of procedural failure, previous CABG, distal vessel disease, occlusion duration have been involved too. Operator''s experience is one of the major success component, especially his ability to perform retrograde approach. According to EuroCTO club recommendations, performing a minimum number of case to maintain competency seems to be very important. [Copyright &y& Elsevier]